A
Child-Centered Approach: Common Themes in the Early Yearsby Joe Cutter

Historically,
orientation and mobility has been taught from adult to adult with particular
emphasis on cane travel. This tradition can be referred to as a "top-down"
approach, adults already having the concepts and learning the motor
schemes to match their comprehension.

With a
pediatric perspective, however, the approach will be "bottom-up." First,
the child learns purposeful movement and out of the relied-upon motor
schemes will come the concepts. During the first two years of life particularly
(known as the sensorimotor stage of development), the child will come
to know and master his/her environment with a lesser or greater degree
of competency. The orientation and mobility specialist will be better
equipped to assist the blind child if knowledge is gained about how
children learn.

The following
list of concepts respects the "bottom-up" approach. It's a peek at some
of the ways blind children will come to know and move in their world.

1. Holistic
Nature of Child. The child is more than the sum of his/her parts.
The child perceives changes in the world and responds to those changes.
The baby does not know, for example, that he/she is seeing or hearing
or touching, but rather experiencing a change in the environment.

2. Development
will be Head to Foot and Proximal to Distal. This is quite significant,
as the blind child's hands and feet will be the last to develop control
in the first year of life. Foot travel and integrity of hand use will
be needed by the blind child for life and yet the blind child is quite
vulnerable in how he/she develops control in them.

3. Play.
Lorraine McCune states: "When play is defined to include all of a baby's
freely chosen encounters with objects, a large proportion of the child's
waking time is play time!" When blind children are restricted in
the kind and amount of play they may be allowed to perform, when they
are limited by others in their free, intentional movement, the context
of their understanding of people, places, and things will also be limited
along with their ability to reason, experiment, and create a more functional
understanding of their world.

4. Reflexive.
Accidental. Intentional. There is an integrative function to the
brain, so that the child learns progressively. The blind child is vulnerable
to not taking advantage of "accidental behavior" (example: hands coming
into view), which has an impact on developing intentional thought. So,
we must provide an appropriate menu of nonvisual experiences that promote
accidental learning in the blind child.

5. Using
Residual Vision. In the early years, residual vision may be ignored
because it is less than "print vision." What may start out as light
perception or projection in the infant may, by two or three years of
age, become more useful. CAUTION: DO NOT PUSH VISION TO THE POINT OF
INEFFICIENCY.

6. Active
vs. Passive Use of Body. Blind children are quite vulnerable in
this area. Often, intentional actions are interrupted by adults doing
for the child. Over time there is a subtle and potentially devastating
concept of the world "reaching to you" and you not "reaching to it."
The role of the orientation and mobility instructor can be instrumental
here, structuring the environment to facilitate the child's movement.

7. Parental
Interaction-CloseIn to Moving Away. First through touch
and sound, attachment occurs, but often during the second year, parents
move to more verbal interaction with children. Blind children may need
a prolonged period of touch interaction here, a period of infant-parent
attunement.

8. Preview.
Lacking sight, the blind baby does not get a visual preview of the world.
How can we provide experiences that will give the blind baby a preview
of his body and the world?

9. Synchrony.
In the early years, blind childrenthe same as sighted childrenuse
two senses at a time instinctively to experience the world. For example,
when babies hear a voice, they turn, expecting to see a face. What of
the blind baby who turns, but does not see a face? Would moving the
arm to feel the face provide a meaningful function? One 13-month-old
baby, when hearing a person's voice on the phone (and not being able
to touch the person), smelled the phone. Was this an attempt to verify
the sound? To synchronize?

10. Affordance.
The structure and function of objects have a lot to do with a child's
interest, amusement, and interaction with them. Giving thought to the
child's play environment can facilitate purposeful thought and movement.